SAN DIEGO, CA—Robots are capable of all sorts of tasks to help better treat cancer: They connect oncologists to patients remotely, make incisions, staple them shut, deliver nano therapies, and clean rooms. New research from infection control specialists found that ultraviolet (UV) robots helped reduce transmission rates of Clostridium difficile, a common bacterial infection among cancer inpatients, particularly blood cancer patients who are 25% more vulnerable to hospital-acquired infections. The intervention also saved approximately $150,000 in annual direct medical costs.
David Pegues, MD, a professor of Infectious Diseases at the University of Pennsylvania’s Perelman School of Medicine and a health care epidemiologist in the Hospital of the University of Pennsylvania Infection Prevention and Control in Philadelphia, presented the data at IDWeek 2015, the annual meeting of the Infectious Diseases Society of America.
Several new cleaning tactics, on top of all the scrubbing, mopping, spraying, and wiping performed by Environmental Services (EVS) professionals, have been implemented at hospitals across the United States to help reduce transmission of such infections, but which new methods are the most effective and practical has remained unclear.
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“There weren’t a lot of studies showing the efficacy of UV lights to clean hospital rooms,” said Pegues, who co-authored a recent study that found a lack of evidence for best methods for cleaning hospital rooms. “These results help fill that gap. This is a cost-saving measure that showed a sizeable reduction in infections for a high-risk group of patients and set the stage for further implementation of the technology at our hospitals.”
The team found that using an ultraviolet germicidal irradiation robot after a room cleaning by EVS not only reduced the number of infections in cancer patients compared with the year prior with no robot, but did so without adversely impacting room turn around. They also report that infections increased by 16% on units without the robot during the study period.
C difficile are not as deadly as other bacteria, but they are harder to clean away. They form spores that are resistant to many disinfectants and can persist in the hospital environment for months. Approximately 500,000 people contract C difficile while in the hospital every year in the United States, and nearly 15,000 people die directly from the infection. Cancer patients, whose immune systems may be compromised from stem cell transplants and/or chemotherapy, are more susceptible to infections than other inpatients.
In 2013, the number of cases of C difficile on the cancer units studied at Penn were 5 times the rate of all the other units in the hospital combined, despite targeted evidence-based interventions and EVS process improvements, including the use of bleach for daily and terminal room cleaning of C difficile rooms.
For the study, the researchers compared C difficile rates from that year to rates in 2014 (when the robot was deployed). The vast majority of the patients on these oncology floors were being treated for blood cancers, including leukemia and multiple myeloma.
During 2014, the researchers used the ultraviolet robot for 21.1% of all patient discharges (542 out of 2,569 total patient discharges) on 3 study units (approximately 10 deployments for a week). Following cleaning of the room by EVS, the robot was deployed for 2 8-minute cycles on either side of the patient bed with the bathroom door left open.
The researchers compared the rates of C difficile, and found a 25% reduction in cases during the 52-week intervention period versus the baseline period, 2013. There were 87 cases of C difficile on the study units in 2013, and 66 in 2014. Surprisingly, this intervention did not impact room turnaround. The mean clean time was roughly the same, approximately 36 minutes.
